Effects and related factors analysis of tigecycline on the level of plasma fibrinogen in the hospitalized patients

Objective To explore the effects and the related factors of tigecycline on the level of plasma fibrinogen in hospitalized patients. Methods The medical records of the patients who were hospitalized and treated with tigecycline in Peking Union Medical College Hospital from January first 2015 to December 31th were collected. The patients′ age, sexuality, primary disease, infection site, days in ICU, situation of using tigecycline, situation of drug combination, the results of tests of fibrinogen (FIB), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), total bilirubin (TBil), and alanine aminotransferase (ALT) before and after medication were recorded. The patients were divided into FIB decreasing group (FIB<1.8 g/L) and non FIB decreasing group according to the test results of FIB during the medication. The risk factors of FIB decreasing after administration of tigecycline were analyzed by the Logistic regression method. Results A total of 121 patients were enrolled into the analysis. There were 59 cases in the FIB decreasing group and 62 cases in the non FIB decreasing group, respectively. The age of patients, the proportion of cases number of primary disease as shock, dysfunction of blood coagulation or bleeding, the proportion of cases of medication time over 14 days in the FIB decreasing group were higher than those in the non FIB decreasing group [(66±13)years vs. (58±16) years, P=0.004, 76.3% (45/59) vs. 56.4%(35/62), P=0.021, 44.1% (26/59) vs. 21.0% (13/62), P=0.007, 42.4% (25/59) vs. 17.7% (11/62), P=0.003]. The number of kind of combination with other antibiotic or antiviral drugs in the FIB decreasing group were more than those in the non FIB decreasing group [3(2, 4) vs. 2(1, 3), P=0.038]. The valley value of FIB during the medication in the FIB decreasing group [1.4(1.1, 1.6) g/L] was obvious lower than those before medication [3.5(2.8, 4.4) g/L] and after drug withdrawal [1.8(1.5, 2.3) g/L] (all P<0.01 ). The peak values of PT, APTT, TT, and TBil during the medication in the FIB decreasing group were obvious higher than those before medication [17(16, 21) s vs. 14(13, 16) s, 57(47, 81)s vs. 39(33, 46) s, 23(21, 26) s vs. 17(16, 20) s, 26(15, 73) μmol/L vs. 15(10, 25) μmol/L, all P<0.01]. All the indices above-mentioned were returned to the levels before medication after drug withdrawal except TT[20(18, 21) s]. The results of Logistic regression analysis showed that the age (OR=1.043, 95%CI: 1.012-1.074, P=0.006), dysfunc-tion of blood coagulation or bleeding (OR=2.843, 95%CI: 1.151-7.022, P=0.024), and medication time over 14 days (OR=3.570, 95%CI: 1.317-9.876, P=0.012) were the risk factors of FIB decreasing after using tigecycline. Conclusions The incidence of FIB decreasing in hospitalized patients after using tigecycline is about half. The age, dysfunction of blood coagulation or bleeding and medication time over 14 days are the risk factors of FIB decreasing after using tigecycline. Key words: Fibrinogen; Hospitalized patient; Tigecycline